Alfred Deakin Research Institute

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Saving Lives At Birth

Mon, 25 Jun 2012 15:36:00 +1000

By Deakin Research Communicationsryan.raybould@deakin.edu.au

Deakin University researcher Associate Professor Liz Eckermann is working to reduce the morbidity rates of mothers and infants in Lao PDR by gaining a better understanding of ancient customs called Yu Fai and Mother Roasting.

Yu Fai, literally meaning ‘on fire’, occurs in a number of countries throughout South East Asia when after giving birth, a mother lies on a bamboo bed either over a brazier containing hot charcoal embers or with the brazier located in the centre of the room.

Women remain on the hotbed throughout their confinement which can range from 10 to 45 days.

The hotbed is only left when the mother undertakes a cleansing ritual otherwise she remains there all day and all night, eats her meals on the bed and nurses her infant with the temperature usually exceeding 50°C.

Mother roasting is a separate activity within the Yu Fai ritual in which the mother exposes herself to high temperatures between 80-100°C generated by hot charcoal embers, either while seated on a chair, while standing crouched over the fire, or while reclining on the bed.

There are many cultural imperatives for women in South East Asia to practice Yu Fai. For them to be good mothers they must adhere to cultural beliefs and practices surrounding the new born infant.

There are also health benefits attributed to yu fai.

However, a high morbidity rate for both mothers and children also needs to be properly investigated.

“Lao PDR is well short of the 2015 targets for Millennium Development Goals in relation to maternal and infant morbidity,” said Associate Professor Eckermann, a member of the Alfred Deakin Research Institute.

“It has one of the highest Maternal and Infant Mortality ratios in the Western Pacific Region.

“Furthermore the levels of maternal and infant morbidity, especially from pneumonia and other respiratory infections, are very high.

“A key likely contributor to post-parity maternal and infant deaths and morbidity is exposure, for both mothers and infants, to extreme heat, carbon monoxide and smoke pollution during the yu fai process which is practiced by over 90% of Lao families for up to 45 days after birth.

“No attempts have been made to examine the impact on the health of mothers and newborns.”

So the key challenges in Associate Professor Eckermann’s project are to:

1. Measure the levels of heat and smoke exposure during "yu fai" and the effects of such exposure on key indicators of health status.

2. Develop the technology to adapt the yu fai ritual such that it is smokeless and within an acceptable temperature range so that it causes no harm to mothers and babies.

3. Generate communication materials and networks to inform communities of the health advantages of smokeless and moderate heat yu fai technology which empowers women in their communities to make healthy choices for themselves and their children

4. Monitor heat and smoke levels with simple and cheap data-loggers and

5. Collate qualitative data on why yu fai is so central to postnatal care and identify what “safe” adaptations would be acceptable to communities unwilling to abandon it.

The world-class nature of Associate Professor Eckermann's research was recently recognised a when she was invited to Seattle In the United States to be among the 65 finalists in the international competition called Saving Lives at Birth: A Grand Challenge for Development.

This challenge came about when USAID, the Government of Norway, the Bill and Melinda Gates Foundation, Grand Challenges Canada, and Britain’s Department for International Development joined together to find the tools and approaches to help the mothers and newborns during their most vulnerable hours.

It seeks ground-breaking prevention and treatment approaches for pregnant women and newborns in poor, hard-to-reach communities around the time of delivery.

This is the period when the majority of maternal and newborn deaths occur and the population that has been the most difficult to reach.

"Melinda Gates and many other funding partners were very interested in the topic," Associate Professor Eckermann said.

"Many had never heard of yu fai.

"I have been invited back again with a prototype product - an adapted rocket stove with damper to control temperature.

"Other funders have also said they will be in touch, so overall, it was a great exchange and well worth the five days of concentrated effort."

Lao PDR has one of the highest Maternal and Infant Mortality ratios in the Western Pacific Region, says Professor Liz Eckermann.

Showcase facts

A key likely contributor to post-parity maternal and infant deaths and morbidity is exposure, for both mothers and infants, to extreme heat, carbon monoxide and smoke pollution during the yu fai process (mother roasting) which is practiced by over 90% of Lao families for up to 45 days after birth.